Chickenpox (varicella)

Most people with chickenpox get better without specific treatment.

Chickenpox rash is very itchy. Scratching should be avoided as this can cause scarring or infection. To help relieve symptoms:

• rest while unwell
• drink fluids
• have a lukewarm bath with an anti-itch solution (e.g. colloidal oatmeal or pinetarsol) added to the water
• apply creams or lotions such as calamine lotion to the skin to reduce itch
• keep fingernails short and use cotton mittens if needed
• take over-the-counter medication such as paracetamol to manage pain or fever.

Aspirin should not be given to children under the age of 16 years old who have chickenpox unless on the advice of a doctor as it can have serious side effects.

People who are very sick might need to go to hospital or be prescribed medication.

Chickenpox is highly contagious and is passed on by coughing, sneezing, or contact with the fluid in the blisters of the rash.

A person with chickenpox can infect others from 1 to 2 days before the rash starts until the blisters have dried.

After having chickenpox, the virus stays in the body without causing symptoms. When the chickenpox virus becomes active again it causes a condition called shingles.  The reason why the virus becomes active again is unknown, but it is more likely when the following happen:

• stress
• sickness
• getting older
• injury
• sickness or treatments that affect the immune system.

People with chickenpox should stay away from childcare, school, or work until all blisters have dried and turned into scabs. This is typically about 5 days.

If you have chickenpox, you can help stop the spread by:

• washing your hands often
• covering your cough or sneeze
• staying away from others until blisters have dried and scabbed over

It is particularly important to stay away from people who are at risk of serious disease, including pregnant women, very young babies or people with weakened immune systems.

Immunisation

There are safe and effective vaccines for chickenpox. Even after vaccination some people can still get chickenpox (breakthrough varicella), but the illness and rash are usually milder. The fluid in the skin lesions in breakthrough varicella can still be contagious.

It is recommended for children to have 2 chickenpox vaccines. A combined measles, mumps, rubella and varicella vaccine (MMRV) is given free to children at 18 months of age.  A second dose is not provided free under the National Immunisation Program. Parents can discuss this and any costs with their doctor or Immunisation provider.

Anyone over the age of 14 who has not previously been vaccinated should have 2 doses of varicella vaccine unless they have a history of chickenpox. It is safe to have a chickenpox vaccine even if you have had chickenpox before.

Vaccination is highly recommended for people at high risk of chickenpox:

• workers where contact with chickenpox is likely (eg. healthcare workers, teachers, childcare staff)
• women planning a pregnancy
• women who have just given birth
• parents of young children
• household contacts of people with weakened immune systems

All vaccines can have side effects, but most are mild and settle quickly. Some people have pain or redness at the injection site, fever, or feel tired.

Sometimes after chickenpox vaccination, a mild chickenpox-like rash may appear at the injection site or on the body. People with this rash should avoid contact with pregnant women and people with weakened immune systems.  If this rash appears, it should be covered until it has crusted over.

Talk to your doctor if you or your child have symptoms after a vaccine that you are worried about.

Sometimes, varicella vaccine can protect a non-immune person if given within 5 days of exposure to chickenpox.

Women who are planning pregnancy

Women planning a pregnancy should check with their doctor to see if they are immune to chickenpox, which can be checked by a blood test if required. Women who are not immune should have 2 doses of a varicella vaccine and avoid getting pregnant for at least 28 days after getting the vaccine.

Women who are not immune and are already pregnant should not have a varicella vaccine until they have had their baby.

Pregnant women who are not immune or who are unsure and think they have been in contact with chickenpox should see their doctor as soon as possible for advice. An injection of varicella-zoster immunoglobulin (VZIG) may be recommended.

If a woman develops chickenpox during pregnancy, there is a small but serious chance of the virus affecting the baby.

For further information, contact your local doctor, health centre or nearest public health unit. You can also call 13 HEALTH (13 43 25 84) 7 days a week at any time.